title: Effect of a pharmacist intervention on asthma control. A cluster randomised trial.
abstract: BACKGROUND
  Achievement and maintenance of good asthma control is a major objective in asthma management. However, asthma control in many patients is suboptimal, due to improper use of asthma medications and non-adherence. The aim of this study was to evaluate the effect of a pharmacist intervention on asthma control in adult patients.
  
  
  METHODS
  A 6-month cluster randomized controlled trial was undertaken with allocation of community pharmacies to intervention or control group. Adult asthma patients in the intervention group received a protocol-based intervention addressing individual needs related to asthma control, inhaler technique and medication adherence. Patients in the control group received usual care. Main variables were measured at baseline, 3 and 6 months.
  
  
  RESULTS
  336 patients completed the study, 150 in the control group and 186 in the intervention group. The intervention resulted in enhanced asthma control: Patients receiving the intervention had an Odds ratio of 3.06 (95% CI:1.63-5.73; p < 0.001) of having controlled asthma six months later. In the intervention group mean ACQ scores significantly improved [0.66 points (SD: 0.78); p < 0.001] and the number of controlled asthma patients increased by 30.1% (p < 0.001) after 6 months. The intervention also resulted in improved medication adherence (by 40.3%, p < 0.001) and inhaler technique (by 56.2%, p < 0.001). No significant changes for any of these variables were observed in the control group.
  
  
  CONCLUSIONS
  The AFasma study focused on the important outcomes of asthma management, and showed that through the designed intervention, community pharmacists can increase controlled asthma patients compared to usual care. Trial registration NCT01085474.
authors.affiliation: Academic Center in Pharmaceutical Care, Faculty of Pharmacy, University of Granada, Campus Universitario de Cartuja s/n, 18071 Granada, Spain. mavigc@gmail.com
authors.forename: Victoria
authors.initials: V
authors.lastname: García-Cárdenas
authors.forename: Daniel
authors.initials: D
authors.lastname: Sabater-Hernández
authors.forename: Patricia
authors.initials: P
authors.lastname: Kenny
authors.forename: Fernando
authors.initials: F
authors.lastname: Martínez-Martínez
authors.forename: María José
authors.initials: MJ
authors.lastname: Faus
authors.forename: Shalom I
authors.initials: SI
authors.lastname: Benrimoj
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000517:prevention & control*; D019819:Budesonide / Q000008:administration & dosage*; D000069502:Budesonide, Formoterol Fumarate Drug Combination; D016000:Cluster Analysis; D003157:Community Pharmacy Services; D004338:Drug Combinations; D004983:Ethanolamines / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D010353:Patient Education as Topic / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents; D000069502:Budesonide, Formoterol Fumarate Drug Combination; D004338:Drug Combinations; D004983:Ethanolamines; D019819:Budesonide
keywords: Asthma; Asthma control; Community pharmacy; Inhaler technique; Medication adherence; Patient education